Probing of the lacrimal canal in newborns as a method of treatment of dacryocystitis

A fairly frequent disease in newborns is dacryocystitis, the cause of which is the obstruction of the lacrimal canal. This disease, according to statistics, is observed in 2-5% of infants. The reasons and tactics of treatment of dacryocystitis are well studied. Often, a tear duct is probed for diagnosis and treatment of the disease.

Causes of the disease

To understand the cause of the disease, we must remember the anatomy of the eye. The structure of the eye is quite complicated. A tear fluid plays an important role in the functioning of this system. A tear is formed in the lacrimal gland, serves to moisturize the conjunctiva and the cornea of the eye. Lacrimal fluid from the eye is drained along the tear ducts. They include a couple of lacrimal points, a pair of lacrimal ducts, a tear sack and a tear duct. The lacrimal fluid enters through the canal into the lower part of the nasal shell, where it evaporates. Dacryocystitis occurs in cases where the connective tissue membrane does not atrophy even before the birth of the child. This membrane prevents the amniotic fluid from entering the tear duct. If it does not break after the first inhalation or scream of the child, then stagnant phenomena occur and the sludge drainage is disturbed. Therefore, the cause of dacryocystitis is a violation of tearing, as well as the attachment of a secondary infection.

Clinic of dacryocystitis

The indisputable early signs of dacryocystitis in a baby are the swelling of the inner corner of the eye, the separation of mucopurulent content, the presence of teardrop and less often lacrimation. Sometimes there is redness of the conjunctiva. But the main, in the clinic of this disease, is an increase in the number of purulent secretions from lacrimal points when pressure is applied to the projection of the lacrimal sac.

To confirm the diagnosis, it is recommended to conduct a collar-gage test ( Vesta test ). It is necessary to drip into the eye 1 drop of 3% solution of collargol. Insert the cotton wick into the nasal passage. If, after five minutes on the wick visible traces of paint, then a positive sample is fixed. A positive sample can also be said when, after instillation of the collargolum, the conjunctiva becomes enlightened within three minutes. The child does not suffer from dacryocystitis, it is necessary to differentiate his condition with other diseases. The increase in the time of staining the wick to 20 minutes indicates a slowed sample, more than 20 minutes - a negative sample. If the result of a tear-nasal test is negative, this fact confirms the diagnosis of dacryocystitis.

For the chronic course of dacryocystitis, a profuse purulent secretion is characteristic, especially after the child sleeps.

After the diagnosis is made, the treatment should be started immediately, as dacryocystitis is dangerous for complications, phlegmon of the lacrimal sac, fistula development. Probably, a lacrimal canal is needed.

Treatment of the disease

Treatment begins with a massage. Massage the child with clean hands. The index finger makes jerky movements from the inner edge of the eye gap (projection of the lacrimal point) along the tear-nasal canal to the wings of the nose. The finger as it wishes to break the embryonic film under the influence of increased pressure in the channel.

• Squeeze the contents of the lacrimal sac, remove it with a sterile cotton swab.
• To inject a solution of furatsillina 1: 5000 in the eye.
• Massage the area of the lacrimal sac by jerky movements up to 10 times from top to bottom.
• Instill a drop of levomycetin 0.25% solution or vitabactum
• Massage 5-6 times a day.

If the massage for two or three weeks does not work, the membrane does not break, and stagnant phenomena persist, then it is necessary to solve the problem of probing the lacrimal canal. This medical intervention is performed in the ophthalmologist's office, preferably at the age of two to three months. Probing of lacrimal canals in infants should be performed only by an experienced specialist.

Probing of the lacrimal canal is carried out under local anesthesia, the baby is tightly swaddled. With the help of conical Sichel probes, starting from a smaller size, lacrimal points and tubules pass. Further, Bowman's probe breaks through the tear-nasal canal webbed. After the eye is probed, the canal is washed with a disinfectant solution.

At home parents should continue to do massage to prevent relapse, instill disinfectant and vitamin drops (floxal 1 drop once a day for 7 days) and periodically show the baby to a specialist. Usually, repeated sounding of the lacrimal canal is not required.

Dacryocystitis is a disease of the newborn, whose treatment is necessary. The timely treatment leads to complete recovery of the child.